Balancing loving and caring in times of chronic illness

2018 ◽  
Vol 18 (3) ◽  
pp. 210-222 ◽  
Author(s):  
G.J. Teunissen ◽  
P. Lindhout ◽  
T.A. Abma
Keyword(s):  
Public Health ◽  
Health Care ◽  
Chronic Illness ◽  
Content Type ◽  
Ethical Care ◽  
Love Relationship ◽  
Public Health Discourse ◽  
The Government ◽  
Health Discourse ◽  
The Impact

Purpose The purpose of this paper is to explore the impact of chronic illness on a couple’s life experiences over a period of 40 years. It critically examines the assumptions of the public health discourse in the light of this couple’s attempts to balance love and health care within their relationship. Design/methodology/approach The couple, the first two authors, put themselves under the magnifying glass. They arranged for a dialogic encounter and built a co-constructed auto-ethnography. This study consists of a “raw” narrative and a reflection. This reflexive part was added by the third author, interpreting the couple’s experiences applying in a sociocultural way theories of ethical care. This sheds light on ethical care aspects encountered in the couple’s balancing of love and health care. Findings This study shows that the couple copes with adversity rather than being in control of it. Nonetheless their love relationship appears to be flourishing, thanks to their acknowledgement of the importance of mutual caring. Research limitations/implications The current public health discourse puts the couple’s private love relationship under pressure. It turns a blind eye towards the difficulties they experience with the contemporary “self-management” paradigm. The couple feels that the government is an interloper intruding into their private relationship. This creates tension, friction, anxiety, as well as increasing the burden of the illness and makes them feel insecure and unsafe. Originality/value The novel method used in this study offers a rare and deep insight.

scholarly journals Social impacts of health care reforms in Russia

2020 ◽  
Vol 210 ◽  
pp. 17011
Author(s):  
Tatyana Tagaeva ◽  
Lidiya Kazantseva
Keyword(s):  
Public Health ◽  
Health Care ◽  
Transition Process ◽  
The State ◽  
Healthcare Sector ◽  
Russian Government ◽  
State Budget ◽  
Factors Affecting ◽  
The Government ◽  
The Impact

The article considers the stages of healthcare sector reforms in Russia and the impact of this process on public health as the main indicator of the social state. A definition of public health is given; the scientific significance and relevance of the research are justified. The works of foreign and domestic authors, their approaches to the study of factors affecting public health are analysed. The analysis of the state of public health in 80s-90s of the last century during the political and economic crisis is made; the transition process from the so-called “budget-funded” financing model to the “insurance” one is described. Based on statistics and expert assessments, as well as international confrontations, conclusions are drawn about the multi-year underfunding of the healthcare sector, primarily from the state budget. A new stage of reforms is analysed: since 2014, the Russian government has begun the so-called “optimization” of healthcare. Its goals, results, feedbacks from doctors and patients are stated. They show the new reform is a negative process for health system. The blunders of health care reform have been sharply marked with the beginning of the pandemic of coronavirus infection. The facts of the self-sacrificing work of the doctors and nursing personnel during the pandemic period, the measures of the Government and the society to support medical workers were described.

Right to health and access to health-care services for refugees in Turkey

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
N. Ela Gokalp Aras ◽  
Sertan Kabadayi ◽  
Emir Ozeren ◽  
Erhan Aydin
Keyword(s):  
Public Health ◽  
Health Care ◽  
Institutional Theory ◽  
Access To Health Care ◽  
Health Care Services ◽  
Public Health Care ◽  
Content Type ◽  
Care Services ◽  
Access To Health ◽  
The Impact

Purpose This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional theory, this paper identifies regulative pillar-, normative pillar- and cultural/cognitive pillar-related challenges that result in refugees having limited or no access to health-care services. Design/methodology/approach The paper draws on both secondary research and empirical insights from two qualitative fieldwork studies totaling 37 semi-structured meso-level interviews, observations and focus groups in three Turkish cities (Izmir, Ankara and Edirne), as well as a total of 42 micro-level, semi-structured interviews with refugees and migrants in one large city (Izmir) in Turkey. Findings This study reveals that systematically stratified legal statuses result in different levels of access to public health-care services for migrants, asylum seekers or refugees based on their fragmented protection statuses. The findings suggest access to health-care is differentiated not only between local citizens and refugees but also among the refugees and migrants based on their legal status as shaped by their country of origin. Originality/value While the role of macro challenges such as laws and government regulations in shaping policies about refugees have been examined in other fields, the impact of such factors on refugee services and well-being has been largely ignored in service literature in general, as well as transformative service research literature in particular. This study is one of the first attempts by explicitly including macro-level factors to contribute to the discussion on the refugees’ access to public health-care services in a host country by relying on the institutional theory by providing a holistic understanding of cognitive, normative and regulative factors in understanding service exclusion problem.

Is it not time for health economists to rethink equity and access?

2009 ◽  
Vol 4 (2) ◽  
pp. 209-221 ◽  
Author(s):  
GAVIN MOONEY
Keyword(s):  
Health Care ◽  
Health Economics ◽  
Health Care Need ◽  
Health Care Equity ◽  
Equity And Access ◽  
Public Health Discourse ◽  
Key Issues ◽  
Definition Of ◽  
Health Discourse ◽  
The Impact

AbstractThis article considers two key issues in health economics regarding the question of equity. First, why have health economists not resolved better the issue of what are equity and access? Second, the paper draws attention to the relative lack of analyses of equity concerns outside of health care. The question of whose values should prevail in equity is also addressed. On the first issue, there is an obsession with quantification in economics with the result that in analysing equity, in practice often ‘use’ has been substituted for ‘access’. The problem of defining access has thereby been by-passed. This has taken the pressure off trying to research access per se. Second, what is meant by equity and access are in part culturally determined. The continued efforts of health economists to treat equity as some universal construct are misplaced. The lack of effort on the part of health economists to look at equity more broadly than health care equity is concerning. Certainly, to be pursued in practice, equity in both health and health care need a shift in resources, which will be opposed by those who exercise power over decision making in health care and in society more generally. Currently health economists’ analyses say all too little about power and property rights in health care and in society. It is argued that the relevant citizens or communities which a health service serves are best placed to judge the access barriers they face and their relative heights. A useful definition of equity established by a citizens’ jury in Perth, Australia is used to exemplify this point. It is concluded that the often all too simplistic equity goals adopted in health economics (and sometimes public health discourse) need to be challenged. For health economists, there is a need for more of us to get involved in the issues around inequalities, class and power and the impact of these on health.

Spain's COVID-19 situation is particularly precarious

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Prime Minister ◽  
Resource Constraints ◽  
Poor Performance ◽  
Public Health Care ◽  
Content Type ◽  
The Government ◽  
Parliamentary Support ◽  
The Eu

Significance The lack of coordination between regions, an inefficient system of testing and tracing and the rapid reopening of society and the economy have contributed to this poor performance. However, the number of deaths has not increased significantly, sparing the healthcare system from the pressure it faced earlier this year. Impacts The disproportionate impact of COVID-19 on Spain's economy will prompt Prime Minister Pedro Sanchez to seek more assistance from the EU. The government can no longer expect parliamentary support from the Republican Left of Catalonia party. Pressures to expand investment in public health care will grow, but resource constraints will limit the government's response.

Addressing operational constraints through Contextual Leadership at a KZN Public Hospital

2018 ◽  
Vol 8 (1) ◽  
pp. 1-18
Author(s):  
Sibongile Zungu ◽  
Kenneth M. Mathu ◽  
Caren Scheepers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Supply Chain ◽  
Healthcare Management ◽  
Public Health Care ◽  
Healthcare Sector ◽  
Accurate Identification ◽  
Content Type ◽  
Contextual Leadership ◽  
The Impact

Subject area Organizational Development; Change Management; Leadership; Healthcare Management Operations; Supply Chain. Study level/applicability MBA; Masters in Healthcare Management; Post-graduate Diploma in Leadership; MPhil in Strategic Leadership. Case overview On April 16, 2016, the CEO of Prince Mshiyeni Memorial hospital, Kwa-Zulu Natal, South Africa, Dr Sandile Tshabalala reflected as he drove through the winding hills of the Cato range. In recent years, the hospital had been a subject of negative publicity with horror stories about patients collapsing while waiting for their medication at one of Durban’s largest hospitals. The case features a number of stakeholders and their demands and even threats. Contextual leadership intelligence requires accurate identification of relevant stakeholders and then involvement in solutions. The case illustrates how these demands had been listened to and how the stakeholders had been involved in finding solutions. A remarkable solution was to realize that the bottleneck at the pharmacy was actually caused by a problem early on in the process, for example, the late start of administrative staff who had to submit patients. A further solution was to utilize the primary health care clinics and even churches for dispensing chronic medicine. Expected learning outcomes Gaining insight and foresight into the operations and supply chain dilemmas in public health care. Developing understanding of the impact of various stakeholders in the healthcare sector. Understanding buy-in when leading change. Acquiring contextual leadership intelligence in the public health environment. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email [email protected] to request teaching notes. Subject code CSS 7: Management Science.

COVID-19 will hit Brazil's indigenous groups hard

2020 ◽  
Keyword(s):  
Public Health ◽  
Amazon Forest ◽  
Health Issues ◽  
Content Type ◽  
Remote Areas ◽  
Public Health Systems ◽  
Indigenous Groups ◽  
Illegal Activities ◽  
The Government ◽  
The Impact

Significance Brazil has a population of around 900,000 indigenous people, mostly living in remote regions of the Amazon forest. The scale of illegal activities in demarcated indigenous areas has been rising and the exposure of indigenous groups to COVID-19 has increased as a result. Impacts The government is unlikely to prioritise environmental and health issues over economic matters in Amazonia. Reduced budgets for governmental inspection bodies will increase the vulnerability of indigenous groups. The lack of adequate public health systems in remote areas will worsen the impact of COVID-19 there.

scholarly journals War of conscience: antivaccination and the battle for medical freedom during World War I

2021 ◽  
pp. medhum-2020-012069
Author(s):  
Susan McPherson
Keyword(s):  
Public Health ◽  
World War I ◽  
Military Service ◽  
Smallpox Vaccination ◽  
Conscientious Objector ◽  
Parliamentary Debates ◽  
Medical Establishment ◽  
Public Health Discourse ◽  
The Government ◽  
Health Discourse

The nineteenth century British antivaccination movement attracted popular and parliamentary support and ultimately saw the 1853 law which had made smallpox vaccination compulsory nullified by the 1898 ‘conscientious objector’ clause. In keeping with popular public health discourse of the time, the movement had employed rhetoric associated with sanitary science and liberalism. In the early twentieth century new discoveries in bacteriology were fuelling advances in vaccination and the medical establishment was increasingly pushing for public health to move towards more interventionist medical approaches. With the onset of war in 1914, the medical establishment hoped to persuade the government to introduce compulsory typhoid inoculation for soldiers. This article analyses antivaccination literature, mainstream newspapers and medical press along with parliamentary debates to examine how the British antivaccination movement engaged with this new threat of compulsion by expanding the rhetoric of ‘conscience’ and emphasising medical freedom while also asserting scientific critique concerning the effectiveness of vaccines and the new laboratory based diagnostic practices. In spite of ‘conscience’ fitting well with an emerging public health discourse of individual subjectivity, the mainstream press ridiculed the idea of working-class soldiers having a conscience, coalescing around the idea that ‘conscientious objection’ be reserved for spiritual, philosophical and educated men who objected to military service. Moreover, in spite of engaging in reasoned scientific critique, parliament and press consorted in the demarcation of scientific knowledge as exclusive to medical scientists, reflecting a growing allegiance between the state and the medical establishment during the war. Any scientific arguments critical of medical orthodoxy were subjugated, labelled as ‘crank’ or ‘faddist’ as well as unpatriotic. The antivaccination narratives around conscience contributed to or were part of an evolving discourse on consent and ethics in medicine. Potential parallels are drawn with current and likely future debates around vaccination and counterhegemonic scientific approaches.

Unfunded Public Employee Health Care Benefits and GASB No. 45

2007 ◽  
Vol 21 (3) ◽  
pp. 245-263 ◽  
Author(s):  
Elizabeth K. Keating ◽  
Eric S. Berman
Keyword(s):  
Health Care ◽  
Financial Reporting ◽  
Full Range ◽  
Financial Reports ◽  
Employment Benefits ◽  
Care Plans ◽  
Advantages And Disadvantages ◽  
Government Accounting ◽  
The Government ◽  
The Impact

The Government Accounting Standards Board (GASB) recently released Statement No. 45, Accounting and Financial Reporting by Employers for Post-Employment Benefits Other Than Pensions and its companion Statement No. 43 for pooled stand-alone health care plans, which will profoundly affect American governmental finance. The goal of this article is to encourage governments to consider carefully a full range of options in funding and restructuring other post-employment benefits (OPEB). This article will review Statement No. 45's potential impact on governments and review existing disclosures in financial reports as well as bond offering statements. The article will discuss the statement's impact on budgets and governmental operations, including collective bargaining. Funding options under Statement No. 45 will be detailed, including the advantages and disadvantages of irrevocable trusts and OPEB bonds. The article will also discuss the impact of Medicare Part D subsidies received by governments, as well as the bond rating implications of policy decisions surrounding OPEB. As the largest government entities are just now implementing GASB Statement No. 45, estimates of the magnitude of unfunded OPEB liabilities are limited as are the strategies likely to be adopted to cover these obligations. This article offers a summary of the unfunded OPEB liabilities reported by states and major cities and suggests some measures for assessing the ability of these entities to address these costs.

scholarly journals Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Care ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Persons Who Inject Drugs ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

Assessing sustainability marketing from macromarketing perspective: a multistakeholder approach

2020 ◽  
Vol 16 (4) ◽  
pp. 287-305 ◽  
Author(s):  
Soha Abutaleb ◽  
Noha El-Bassiouny
Keyword(s):  
Theory Of Planned Behavior ◽  
Planned Behavior ◽  
Purchase Intentions ◽  
Marketing Strategies ◽  
Content Type ◽  
Quantitative Research Methods ◽  
Sustainable Products ◽  
Government Role ◽  
The Government ◽  
The Impact

PurposeThe paper examines three main stakeholders in the market and their roles toward achieving sustainability marketing. Those stakeholders are consumers, companies and policymakers. The current study is examining consumers’ attitudes toward sustainability marketing and their purchase intentions of sustainable products through the use of theory of planned behavior. The paper is also examining the role of companies and policymakers in encouraging consumers to consider sustainability in their purchasing decisions.Design/methodology/approachConcurrent research study is applied, where qualitative and quantitative research methods are conducted at the same time for different purposes with equal weights. Qualitative interviews were applied with fast-moving consumer goods companies and policymakers, while quantitative surveys were applied with Egyptian consumers.FindingsThe results showed that companies are taking serious and effective steps in transforming their marketing strategies into sustainable marketing ones. The government role is still limited as there are no strict laws and regulations that force companies and factories in Egypt to develop sustainability marketing strategies. Consumers’ attitudes were highly affected by firms' sustainable practices as well as subjective norms that led to influencing their intentions toward purchasing sustainable products.Originality/valueAlthough the topic of sustainability marketing is considered by a plenty of researchers in the academic discipline, there are no studies that have combined the main three stakeholders' roles in achieving sustainability marketing in one study. The study highlights the impact of government role and firms' role on consumers' attitudes and purchase intentions toward sustainable products, especially convenient products. This was done through the adoption of the theory of planned behavior.

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